Twilio for healthcare

How Mount Sinai is building patient engagement to drive value-based care

  • Janet Alexander
    Janet Alexander
  • Jul 06, 2020

Read insights about the future of digital communication in healthcare in this conversation between Twilio’s Global Head of Healthcare Services Susan Collins and David Kerwar, Chief Product Officer and head of consumer digital innovation at the Mount Sinai health system.

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In the midst of the COVID-19 pandemic, health services teams around the world are trying to serve patients and their families without putting their health at-risk with in-person visits. Telehealth is making care accessible for those recovering from and managing a symptomatic case of coronavirus, as well as those requiring healthcare services for other health issues.

In New York City, one of the areas hardest hit by the virus early on, major healthcare providers have adapted rapidly to meet patient demand while keeping patients and providers alike safe. These patient-centric trends, though, were underway long before COVID-19, and have effectively been accelerated by the “lightbulb moment” created by the novel coronavirus.

Twilio’s Global Head of Healthcare Services Susan Collins spoke with David Kerwar, Chief Product Officer and head of consumer digital innovation at the Mount Sinai health system—one of the largest health systems in New York—to discuss how he and his team are evolving the provider and patient experience. Below is their conversation, abridged for clarity and brevity.

The future of healthcare communications

Susan Collins:

David, if you don't mind, get us all a high level overview of the Mount Sinai health system and the great work that you and your team are doing.

David Kerwar:

We started in May of 2018, building a team that’s since grown to over 40 people—full-stack engineers, product and strategy folks, and human-centered designers.

The first mandate we’re addressing is how to move away from a fee-for-service business model in healthcare that incentivizes us to try to provide more care in inpatient settings, instead of trying to keep a population healthy by focusing on preventative care and treating patients when they're not in the four walls of our health system.

We built a lot of our solutions bespoke, and we have some incredible partners, like Twilio. For the past two years, it’s given us an incredible way of being able to reach out and engage patients in both a proactive and a reactive manner using SMS, but also engage them with chatbots and live employee chats, step them up to video, and overall, create higher levels of fidelity as we're trying to increase our interaction with that patient.

Susan Collins:

Do you think as an industry that we'll be able to leverage some of the innovation that we've seen adopted during this crisis to create a better consumer experience going forward?

David Kerwar:

Yeah, I certainly hope so. I've been in healthcare for almost 20 years now, and I remember in the early 2000s talking about how we are going to make it easier for patients to find care online.

Now, both patients and providers have used virtual care and digital solutions to try to get or provide care and have done so pretty successfully.

At Mount Sinai, we were doing, let's say tens of video visits before this crisis, currently, on some days we're doing north of 4,000. So both on the patient and provider side they've seen the power of technology and how this is possible.

Our challenge now is taking this beyond possible to actually make it engaging and almost a preferred way of getting care. And then more importantly, you can make a more proactive healthcare experience for the consumer when you use technology in the right way.

Get the ebook about how to provide a more consumer-centric healthcare delivery model.

The unexpected benefits of patient-provider engagement

Susan Collins:

I had an interesting conversation with a physician recently whose previous experience had them feeling that the technology they needed to do their job made it harder to create that relationship and that connection to the person that they were caring for.

But once they started engaging with their patients, they found that the additional information that they received about that patient's situation and circumstances was really very powerful and helpful. And it improved the relationship and the conversation and the quality of the conversation they were able to have. And they really likened that video interaction to more of a house call, the way we used to deliver healthcare, which was, they felt much more personal.

David Kerwar:

We're seeing the same thing as well. When I talk to providers, I hear two parts of feedback around the benefits of a virtual experience. The first part is particularly for a primary care physician in an office-based setting, who has just minutes to get through that visit. It becomes a little transactional. Are you taking your medications? Are you having these symptoms? How's it going with getting this referral? Whatever it might be.

And when it's a virtual visit, it's a little bit more comfortable. And I think because the provider and the patient are in more of their sort of natural habitats, for lack of a better term, you're able to see more about the patient.

From a mental health perspective, you can tell a lot of things about a patient just by actually being able to see them in a more relaxed environment. So, I think it makes for a more authentic, in some ways, experience for both. It will never replace in-person care, but it's an incredible complement to it.

The second thing we've noted is caregiver access. For some more elderly patients, interacting with a chatbot and subsequently a video chat can feel like a pretty complex kind of technology experience.

So we created a lot of connections with proxies, the patient's children, the patient's home health nurse, or the patient's cousin, or whomever it might be. And that's for our providers to have a really powerful relationship with the caregiver that they don't necessarily always get when they're just seeing those patients in their office.

Adapting to COVID-19 with customer engagement channels

Susan Collins:

Has Mount Sinai had an experience where this technology is enabling better access for underserved communities or those who struggle to access the typical healthcare delivery system due to lack of transportation, or family, for example?

David Kerwar:

Yeah, definitely––no better example than COVID-19, right? Overnight, COVID-19 mandated virtualizing the healthcare experience for our chronic disease population--whether it's heart, diabetes, cancer, what have you––and caring for all COVID-19 patients, regardless of their native language, socioeconomic status, and making it user-friendly.

So how do we create a digital experience that works for all of them? Through Twilio, we've registered a short code, 474624. A patient can text that, and they're brought into our secure environment, and from there they can get a video visit. They can ask questions about COVID-19, they can follow any one of our digital care management programs that they've maybe been enrolled in. They can talk to a navigator.

And we see much higher levels of engagement there, and we've actually researched, and it turns out that when you talk to patients that might be older or patients that might be poorer, they're a little stressed at having to load native mobile apps. Sometimes they're on pay as you go data plans, and they don't want to have that app sitting on their desktop. Texting enables us to have high levels of engagement and start the conversation from a clinical perspective.

Learn more about how Twilio helps healthcare providers engage throughout the patient journey.

What healthcare can learn from consumer-driven industries

Susan Collins:

Before we close, I'm wondering is there anything that you think was particularly important in making this program successful?

David Kerwar:

I think one of the things we did early on was a fair amount of journey mapping with providers and consumers to really understand what their experience was like. And one of the big things that we decided was the right sort of interaction needs to be highly digital, but also omni-channel. And it doesn't replace the in-person, it sort of complements it.

If you are thinking about transforming the business model of healthcare, the first thing you have to think about is how do you create a consumer-centric experience so those consumers continue to come back to you? You're no longer just beholden to an insurance company to maintain great rates, now you are really serving consumers directly.

And those were things that were taught to us by not a bunch of research, but through some really in depth interviews with consumers providers, current patients, prospective patients, things like that. So I think it's incredibly important to get into the minds and the shoes. And that's been a big part of what's formed our product strategy from the beginning.

Susan Collins:

That's absolutely fantastic work. I can't thank you enough for joining us today and sharing all this incredible insight.

David Kerwar:

Thanks so much, Susan.

Watch the webinar

Watch the full conversation about how the healthcare industry can best navigate the current COVID-19 crisis while preparing for the future.

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Janet Alexander

Janet Alexander

Janet has a decade of professional writing experience. With a focus on B2B technology, she helps Twilio's subject matter experts, product managers, and customers share their expertise, knowledge, and unique points of view through thought leadership, storytelling, and customer resources.